Turning That Frown Upside Down

America is, and always has been, a real “We can do it” place. Without optimism and fortitude, would the Founding Fathers have even gathered in Philadelphia, or simply looked at the odds and decided instead to just have a nice cup of tea? Lady Liberty is in the New York Harbor, a beacon of light that indicates anyone can accomplish anything if they just try hard enough.

Unfortunately, the idea of just toughing it out and putting on a brave face has hidden a major health issue—one that is finally gaining more attention in the public eye. An estimated 44 million Americans experience a mental disorder annually, according to the National Mental Health Center. In fact, mental illnesses are among the most common conditions affecting health in the United States.

Perhaps the best-known mood disorder is depression. Major depressive disorder is the leading cause of disability in the United States for ages 15 to 44; it affects approximately 14.8 million American adults annually, according to the National Institute of Mental Health (NIMH). A related condition, dysthymic disorder, is considered chronic, mild depression and lasts for at least two years. About 3.3 million American adults will meet the criteria for that diagnosis annually.

While researchers do not know the exact mechanisms that trigger depression, two neurotransmitters, serotonin and norepinephrine, are implicated in the condition, which can manifest with symptoms such as changes in appetite, feelings of hopelessness, fatigue, sadness, headaches and mental distraction. In addition, research cited by the Depression and Bipolar Support Alliance shows major depression often co-occurs with other illnesses: 25 percent of cancer patients, up to 27 percent of post-stroke patients and diabetics, and one in three heart attack survivors.

Three major types of medication are used to treat depression: tricyclics; selective serotonin re-uptake inhibitors (SSRIs)—designed to keep the feel-good hormone serotonin in the system—and monoamine oxidase inhibitors (MAO inhibitors), which prevent the enzymatic breakdown of neurotransmitters such as serotonin and dopamine in the brain.

Even more pervasive in society are anxiety disorders, affecting 40 million U.S. adults age 18 and older—18.1 percent of the population—according to Anxiety Disorders Association of America. The health costs associated with anxiety disorders go beyond just treatment of the condition, as the association noted people with an anxiety disorder are three to five times more likely to go to the doctor, and six times more likely to be hospitalized for psychiatric disorders, than those who do not suffer from anxiety disorders.

While prescription treatments for mental illnesses have brought in a huge amount of dollars to the pharma industry, it is projected that those revenues will fall in the coming years. A report from Research & Markets projects the depression pharma market will peak at $14.6 billion in 2010, and then drop value due to generic incursion thereafter. Similarly, Datamonitor research suggests the global market for treating anxiety disorders will likely decline from $4.5 billion in 2006 to $2.6 billion by 2015, again due to the release of numerous generic anxiety drugs.

At the same time, there is a growing interest among consumers in treating mood issues. According to the Natural Marketing Institute’s 2007 Health & Wellness Trends Database, 37 percent of consumer households are treating anxiety, while 20 percent are treating depression. However, there is a big opportunity gap for marketers, as only 4 percent of consumers are using condition-specific supplements for mood and depression.

“Without question, this is a growing category,” said Deanne Dolnick, director of sales, Next Pharmaceuticals. “The economy is causing the average person to feel a great deal of anxiety. I think those who typically don’t get anxious or depressed may be more likely to fall into those categories now.” Dolnick added the side effects associated with prescription medications—such as weight gain or sexual dysfunction—are spurring consumers toward natural solutions.

Ram Chaudhari, Ph.D., senior executive vice president and chief scientific officer, Fortitech Inc., agreed with the assessment. “Today’s consumers have pushed the industry to look for natural alternatives to drugs typically prescribed for depression,” he said. “As with many other conditions, the wave of first response through pharmaceutical remedy is followed by the emergency of consumer interest in more ‘natural’ approaches through dietary supplements or fortified food products that may be associated with fewer unwanted side effects.”

While consumers have been interested in natural solutions to depression for a long while, Rodger Rohde, president, Triarco, said interest is on the rise. “Consumers have a renewed interest, as research begins to show these conditions may be influenced by more than one factor,” he said. “They have keyed into the fact that there may be things they can do, proactively, to help combat depression and anxiety.”

Mitch Skop, director of new product development, Pharmachem Inc., summed up: “Now is the perfect time for manufacturers to consider either revamping or creating new supplements and functional foods that help naturally provide relief of the ravages of stress, promote restful sleep, and lift and sustain a healthier, lighter mood.”

Natural Mental Health Ingredients:

• Basic Nutrition
• Fats
• Botanicals
• Specialty compounds

As formulators look to expand their product lines, adding value to existing offerings is one solution. Chaudhari reiterated that anxiety and depression often are seen in patients with other health issues such as cardiovascular disease, menopause or arthritis. “Products that have already been successfully targeted to specific health conditions where stress or depression is an associated condition may gain added value by reformulation,” he said, suggesting adding mood-supporting nutrients to bars targeted to menopausal women or to joint health supplements for arthritis sufferers. The value-added aspect additionally adds differentiation in an increasingly crowded marketplace.

Whether included in a multi-faceted health product, or simply combined for maximum efficacy in treating anxiety and stress, well-researched nutritional ingredients for these conditions have much to offer consumers. Using a little optimism and fortitude in entering this market could yield both happy customers and a healthy bottom line.